You finally finished interview season and it’s time to create your rank list. While it may seem like an easy task, some applicants find conflicting opinions on how to rank programs. 

Many applicants start pondering if they left a good impression, which programs sounded like they are seriously considering the applicant, and where in the list will they match, if at all. In this article, we will discuss what you should consider before creating your list to help alleviate some of the anxiety. 

  1. Trust your gut
  2. Small vs large programs
  3. Gain a different perspective
  4. Sort out your priorities 
  5. The sooner the better
  6. Do not be impulsive


  • Trust your gut

A great tip made by past matched applicants is to simply trust your gut. An applicant could have set his mind to match in a university-based hospital but changed his mind to a community hospital based on how the interview went, or vice versa. 

One helpful tip is to note down how you felt during the interviews. Were you comfortable? Was the interviewer interested in what you had to say? Was the hospital environment welcoming, i.e. did the program have organized interview sessions and statements that were aimed to make you feel welcomed (virtual season)?  Make sure to not let people’s opinions shadow your gut feeling. After all, the people in the program you match with will be your future companions. If you’re comfortable from the get-go, you are more likely to be a comfortable fit at the program. 


  • Small vs large programs 

Programs range from community to university-based programs. Small programs usually have a smaller number of peers who usually become a close-knit community over the years of residency. Meanwhile, larger programs usually train at different sites, exposing you to a diversity of both patients and doctors. Opinions vary when it comes to the small vs. large programs debate, however, it really doesn’t matter in the grand scope of things. It all boils down to your preference and what you want your residency experience to be like. 

For instance, if you’re training in a small surgery program, the chances of you seeing and operating on a common procedure like an appendectomy are much higher. You’d probably graduate operating on at least 300 appendectomies. However, training in a large program will allow you to diversify your portfolio, and see more unusual cases. Find your personal fit and what you’re inclined to do. 


  • Gain a different perspective

If a particular program sparks an interest, reach out to its residents to gain a deeper perspective. Ask about work culture, living costs, and neighborhoods to live in. If you’ve ever shadowed a doctor in a program you’re interested in, reflect how you felt in the hospital. Even better, reach out to the residents that you worked with and ask them how they would rate their work environment. Would you like to work with an energetic, active, and passionate staff? Ask the residents what methods are used in their teaching environment, how they are motivated to learn every day and what they are looking forward to when they finish training. You’d be surprised by the variety of answers. 

A fellow senior who was an aspiring emergency medicine physician had his list narrowed down to two programs and couldn’t decide which one to rank at the top. After looking up the geographical location of the hospitals and asking the residents about the type of cases they see, he learned that one of the programs was located in an area with a high rate of road traffic accidents. Reflecting on the type of injuries and emergency cases he’d see outside of the bread and butter of EM, he decided that it would be the perfect place to get his hands on them. Kind of a morbid way to think about it, but hey, it worked out for him!


  • Sort out your priorities 

In a survey conducted by NRMP in 2021, applicants submitted the factors that play an important role when considering ranking a program on their final Match Order list. They include the following: 

  • The overall goodness of fit—89%.
  • Interview day experience—82%. 
  • Desired geographic location—77%. 
  • Quality of residents in the program—75%. 
  • The reputation of program—71%

For instance, if you’re planning to stay in a desired location (spouse, family, etc) make sure to come to terms that you may land geographically anywhere on your rank list. So if you’re set on staying in a certain area it would be a good idea to not rank the program at all. 

While these may be the most common priorities, you can have a different set of priorities. A good approach would be to create an excel sheet with columns listing your priorities. Fill them out as interview season progresses. By the end, you’ll have a comprehensive sheet of your initial thoughts and ranking of the programs. This will alleviate some of the stress and help you make a well-thought-out list. 


  • The sooner the better

Submitting your rank list last minute is a bad idea. You and thousands of applicants might be in the race for time by the end of the season if the website crashes. As soon as you finish interviewing with a program, add the program to your list based on your priorities. 


  • Do NOT be impulsive

Many applicants make last-minute changes to their list before submission. Unfortunately, many applicants regret these decisions because they are made in a moment of impulsiveness and not the result of a well-thought-out process. The best approach is to schedule your interviews well ahead of time (2 weeks give or take) of rank list submission. This will give you time to research, ask around, and come to a final list that satisfies your goals. 

Again, at the end of the day, it all boils down to your gut feeling. If you feel drawn to a certain program, evaluate your odds, ask their residents for insight, and make sure they know you’re interested in their program. This journey is not easy, so if you’re looking for a professional opinion make sure you reach out to your advisor/mentor.

And finally, good luck!

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